Anaesthetists Handbook - MEDICAL EDUCATION at University ...

Fractured neck of femurIf the patient fulfils the following criteria they are unfit and should notbe starved and scheduled for surgery• Uncontrolled blood pressure:Systolic > 200 mmHgDiastolic > 100 mmHg)• Uncontrolled heart rate once resuscitated (100 bpm)• Electrolyte derangement:Sodium < 127 mmol L -1Potassium < 3.2 mmol L -1Potassium > 5.6 mmol L -1• Anaemia:Hb < 8 g dL -1 (and no evidence of ischaemic heart disease)Hb < 10 g dL -1 (with evidence of ischaemic heart disease)• Uncontrolled hyperglycaemia: glucose > 16 mmol L -1• Evidence of severe aortic stenosis or acute myocardial infarction• Acute embolic disease: PE, CVA, fat embolismPatients fulfilling the following criteria should be discussed with theanaesthetic team who will decide when they should be starved andscheduled for theatre• Raised INR (FFP may be required for the scheduled theatretime)• Severe chronic airways disease (ensure arterial blood gasresults available)• Renal or cardiac failureFor the management of patients with diabetes mellitus see page155.152 Anaesthetists Handbook January 2010